National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 297542

Case Details

VAERS ID: 297542 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Male  
Location: Unknown  
Vaccinated:2007-08-23
Onset:2007-11-06
   Days after vaccination:75
Submitted: 2007-11-20
   Days after onset:14
Entered: 2007-11-23
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B133AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF162AB / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007E / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0668U / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Haematochezia, Intussusception, Laboratory test, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory. Labs and Diagnostics: Abdominal US (+) IS. Air Enema (+) for IS
CDC Split Type: WAES0711USA02907

Write-up: Information has been received from a physician and a nurse concerning a 4 month old male (also reported as 19 weeks old) who on 23-AUG-2007 was vaccinated with Rotateq (Lot # 657615/008U). Concomitant therapy included ActHIB, Prevnar and Pediarix all given on 23-AUG-2007. The physician reported that the patient experienced vomiting and blood in the stool and on 06-NOV-2007 the patient was diagnosed with intussusception. The nurse reported that the patient had surgery and is "doing fairly well now." Additional information has been requested. 11/28/2007 Vax record received. Info updated in VAERS database. 02/01/2008 MR received for DOS 11/6-7/2007 with D/C DX: Dehydration. 2'' DX: Intussusception s/p reduction by air enema. Pt presented to ER with 2 day hx of crampy abdominal pain, and intermittant lethargy, nausea and vomiting. Decreased UO and PO intake. IS noted on Air enema and reduced by same. Pt had one bloody bowel movement then a normal one following. D/C home next day with good po intake and UO.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=297542


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166